Healthy Nantucket 2020 - Nantucket 2017 Community Health Improvement Plan February 2017 - Nantucket Cottage Hospital

 
Healthy Nantucket 2020 - Nantucket 2017 Community Health Improvement Plan February 2017 - Nantucket Cottage Hospital
Healthy Nantucket 2020
Nantucket 2017 Community Health Improvement Plan

February 2017
Healthy Nantucket 2020 - Nantucket 2017 Community Health Improvement Plan February 2017 - Nantucket Cottage Hospital
INTRODUCTORY LETTER
Dear Community Partner,

Healthy Nantucket 2020, the Nantucket 2017 Community Health Improvement Plan, is the result of
extensive collaboration among the island’s health and human services agencies, non-profit
organizations, the Town of Nantucket’s Department of Health, as well as year-round and seasonal
residents of the island.

From September 2016 through January 2017, these community stakeholders came together during
a series of public forums and meetings to identify Nantucket’s most pressing health needs, prioritize
the top issues for the island, and develop goals and strategies to make meaningful change in these
areas. During this collaborative and participatory process, dozens of community groups,
organizations, and individuals contributed valuable insight and perspectives.

The resulting document, Healthy Nantucket 2020, reflects this comprehensive process and the wide
range of community stakeholders who offered their expertise and knowledge. This plan does not
belong to Nantucket Cottage Hospital or any other single entity, but is rather the community’s plan
to address the most important health issues we face.

In the weeks, months, and years ahead, we look forward to implementing the strategies identified in
this plan, developing innovative and collaborative solutions, and achieving the goals we have set
together to improve the health and wellbeing of the Nantucket community.

Thank you for joining with your friends, neighbors, and colleagues in contributing toward this
important endeavor.

Sincerely,

Margot Hartmann, MD, PhD        President & CEO, Nantucket Cottage Hospital
Tucker Holland                  Housing Consultant, Town of Nantucket
Paula Leary                     Administrator, Nantucket Regional Transit Authority
Kevin Marshall                  Sergeant, Nantucket Police Department
Beth Ann Meehan                 Mortgage Lending Officer, Cape Cod Five Cent Savings Bank
Nick Ouellette, DC              Chiropractic Physician
Jamie Roberts DMD               Paul Roberts, DDS
Tracy Roberts            Family Activities Specialist, Nantucket Community School
Alex Rosenberg                  Site Manager, Nantucket Family Planning
Roberto Santamaria              Director, Town of Nantucket Health Department

Healthy Nantucket 2020: Nantucket 2017 Community Health Improvement Plan                         Page 2
Table of Contents
INTRODUCTORY LETTER ...........................................................................................................2
EXECUTIVE SUMMARY ..............................................................................................................4
HEALTHY NANTUCKET 2020: NANTUCKET 2017 COMMUNITY HEALTH IMPROVEMENT PLAN ........6
I.     BACKGROUND .................................................................................................................6
II.    OVERVIEW OF HEALTHY NANTUCKET 2020 .......................................................................6
       What Is a Community Health Improvement Plan? ..................................................................................... 6
       How To Use The Community Health Improvement Plan ........................................................................... 6
       Relationship Between the Community Health Improvement Plan and Other Guiding Documents and
            Initiatives ............................................................................................................................................ 7
       Methods ...................................................................................................................................................... 7

IV.    PROCESS FROM ASSESSMENT TO PLANNING .....................................................................8
V.     HEALTHY NANTUCKET 2020 PLAN COMPONENTS ..............................................................8
       Development of Data-Based, Community-Identified Health Priorities ....................................................... 8
       Priorities Identified for Healthy Nantucket 2020 ....................................................................................... 11
       The Plan’s Strategic Framework .............................................................................................................. 11

VI.    HEALTHY NANTUCKET 2020 .......................................................................................... 11
       Priority Area 1:        Behavioral Health ........................................................................................................... 12
       Priority Area 2:        Women’s and Children’s Health ..................................................................................... 16
       Priority Area 3:        Access to Health Care.................................................................................................... 19
       Priority Area 4:        Access to Housing.......................................................................................................... 22

VII. NEXT STEPS ................................................................................................................. 25
VIII. SUSTAINABILITY ............................................................................................................ 25
IX.    ACKNOWLEDGEMENTS ................................................................................................... 26
       Steering Committee.................................................................................................................................. 26
       Prioritization Session Participants ............................................................................................................ 26
       Planning Session Participants .................................................................................................................. 28
       Consultant Advisors ................................................................................................................................. 28

APPENDIX A: ACRONYMS ...................................................................................................... 29
APPENDIX B: GLOSSARY OF TERMS ....................................................................................... 30

Healthy Nantucket 2020: Nantucket 2017 Community Health Improvement Plan                                                                                     Page 3
EXECUTIVE SUMMARY
It is critical to understand the specific environmental factors on Nantucket -- where and how we live,
learn, work, and play, and how they in turn influence our health -- in order to implement the best
strategies for community health improvement. To accomplish this goal, Nantucket Cottage Hospital
led a comprehensive community health planning effort to measurably improve the health of
residents on the island. This effort included two major phases:

    1. A community health needs assessment (CHNA), conducted by Nantucket Cottage Hospital,
       to identify the health related needs and strengths of the island community, and

    2. A community health improvement plan (CHIP) to determine major health priorities,
       overarching goals, and specific objectives and strategies that can be implemented in a
       coordinated way to address these needs.
The CHNA and CHIP are essential frameworks for guiding future services, programs, and policies
for healthcare and public health-serving agencies on the island.
Healthy Nantucket 2020, the 2017 Community Health Improvement Plan, was developed over the
period September, 2016 - December, 2016, using the key findings from the CHNA. The 2015
Nantucket Community Health Needs Assessment is part of Nantucket Cottage Hospital’s ongoing
efforts to assess the health needs of the island community. This effort included focus groups with
the Healthy Community Collaborative and Nantucket Cottage Hospital’s Patient & Family Advisory
Council, as well as a Quality of Life survey that was distributed widely throughout the community.
The 2015 CHNA is accessible at:
http://nantuckethospital.org/wp-content/uploads/2015/08/NCH-2015-CHNA.pdf
To develop a plan for improved community health, and help sustain implementation efforts, the
community health assessment and planning process engaged community partners through different
avenues. These partners included a cross-sector of community members such as health care,
businesses, public safety, schools, emergency response services, holistic healthcare, planning and
development, and transportation, as well as year-round and seasonal residents.

In 2016, Nantucket Cottage Hospital engaged Health Resources in Action (HRiA), a non-profit
public health organization located in Boston, MA, as a consultant partner to provide strategic
guidance and facilitation of the Community Health Improvement Plan process, to review and
provide feedback on draft documents and output, and to develop the resulting plan.

The Steering Committee met at a kick-off meeting on September 13, 2016 to receive an overview of
the planning process, review data outcomes from the CHNA, and review the proposed process and
timeline for engaging community members.

Three Community Forums were held to confirm the CHNA findings and gather additional community
input. On September 20, 2016, Health Resources in Action, Inc. (HRiA) facilitated two community
forums at Nantucket High School. A third community forum, facilitated by Nantucket Cottage
Hospital, was held on October 2, 2016 following the Spanish Mass at St. Mary’s Church.

During the Community Forums, CHNA findings were shared as well as an overview of the
prioritization process for identifying Community Health Improvement Plan priorities. Participants
then took part it a facilitated discussion designed to gather input on the CHNA findings as well as
feedback on health needs that were not captured in the CHNA.

Healthy Nantucket 2020: Nantucket 2017 Community Health Improvement Plan                         Page 4
Health Priorities
A group of over 60 key stakeholders gathered on October 6, 2016 to identify the priorities for the
Community Health Improvement Plan. After reviewing the CHNA findings, participants provided
feedback on other health priorities to be considered as part of the prioritization process.
Participants then used a rating tool and with defined criteria and a voting process to identify those
health needs that were both important and feasible for inclusion in the plan.
Three key priorities were selected for planning: Behavioral Health, Access to Healthcare, Women’s
and Children’s Health, and Access to Housing. Language was proposed and agreed upon as a
cross-cutting strategy. Language includes translation services, availability of services and materials
in multiple languages, and the availability of English classes.

          Priority Area                                     Goal Statement
                                     Goal 1: Enhance overall wellness for the Nantucket community
Priority 1: Behavioral Health                through the implementation of an effective and
                                             collaborative Behavioral Health System.
Priority 2: Women’s and              Goal 2: Improve the health, safety, and well-being of all women,
            Children’s Health                infants, children, and families of the diverse Nantucket
                                             community.
Priority 3: Access to                Goal 3: Enhance access to healthcare for the Nantucket
            Healthcare                       community.
Priority 4: Access to                Goal 4: Ensure access to safe, stable, affordable, year-round
            Housing                          housing across all income levels.

A group of key stakeholders met for two, half-day planning sessions in November 2016 to develop
the core elements of the Community Health Improvement Plan. In the first planning session,
participants developed and revised goals, and developed draft objectives and indicators. In the
second planning session, participants finalized their draft objectives and indicators, and developed
strategies to meet each objective. The output of these two sessions follows below.

Healthy Nantucket 2020: Nantucket 2017 Community Health Improvement Plan                         Page 5
HEALTHY NANTUCKET 2020:
NANTUCKET 2017 COMMUNITY HEALTH IMPROVEMENT PLAN

    I. BACKGROUND
        It is critical to understand the specific environmental factors on Nantucket -- where and how
        we live, learn, work, and play, and how they in turn influence our health -- in order to
        implement the best strategies for community health improvement. To accomplish this goal,
        Nantucket Cottage Hospital led a comprehensive community health planning effort to
        measurably improve the health of residents on the island. This effort included two major
        phases:
          1. A community health needs assessment (CHNA), conducted by Nantucket Cottage
             Hospital, to identify the health related needs and strengths of the island community, and

          2. A community health improvement plan (CHIP) to determine major health priorities,
             overarching goals, and specific objectives and strategies that can be implemented in a
             coordinated way to address these needs.

        The CHNA and CHIP are essential frameworks for guiding future services, programs, and
        policies for healthcare and public health-serving agencies on the island.

    II. OVERVIEW OF HEALTHY NANTUCKET 2020
        What Is a Community Health Improvement Plan?
        A Community Health Improvement Plan, or CHIP, is a data-driven, collective, action-oriented
        strategic plan that outlines the priority health issues for a defined community, and how these
        issues will be addressed, including strategies and measures, to ultimately improve the health
        of the community. These plans are created through a community-wide, collaborative planning
        process that engages partners and organizations to develop, support, and implement the plan.
        A Community Health Improvement Plan is intended to serve as a vision for the health of the
        community and a unifying framework for organizations to use in leveraging resources,
        engaging partners, and identifying their own priorities and strategies for community health
        improvement.1
        Building upon the key findings and themes identified in the 2016 Community Health Needs
        Assessment (CHNA), the Community Health Improvement Plan:
             Identifies priority issues for action to improve community health
             Outlines an implementation and improvement plan with performance measures for
               evaluation
             Guides future community decision-making related to community health improvement

        How To Use The Community Health Improvement Plan
        A Community Health Improvement Plan is designed to be a broad, strategic framework for
        community health, and should be modified and adjusted as conditions, resources, and
        external environmental factors change. It is developed and written in a way that engages
        multiple perspectives so that all community groups and sectors – private and nonprofit
        organizations, government agencies, academic institutions, community- and faith-based
        organizations, and citizens – can unite to improve the health and quality of life for all people
        who live, work, learn, and play on Nantucket. We encourage you to review the priorities and
1
    As defined by the Health Resources in Action, Strategic Planning Department, 2012

Healthy Nantucket 2020: Nantucket 2017 Community Health Improvement Plan                            Page 6
goals, reflect on the suggested strategies, and consider how you can participate in this effort,
      in whole or in part, as either an independent contributor or as a member of a health-focused
      agency, organization, or group. Consider: How do your current plans align with the CHIP?
      How can your future plans align with the CHIP?

      Relationship Between the Community Health Improvement Plan and Other
      Guiding Documents and Initiatives
      The Community Health Improvement Plan was designed to complement and build upon other
      guiding documents, plans, initiatives, and coalitions already in place to improve the public
      health on Nantucket. Rather than conflicting with or duplicating the recommendations and
      actions of existing frameworks and coalitions, the participants of the planning process
      identified potential partners and resources already engaged in these efforts wherever
      possible.

      Methods
      Following the guidelines of the National Association of County and City Health Officials
      (NACCHO), the community health improvement process was designed to integrate and
      enhance the activities of many organizations’ contributions to community health improvement,
      building on current assets, enhancing existing programs and initiatives, and leveraging
      resources for greater efficiency and impact. To develop the Community Health Improvement
      Plan, Nantucket Cottage Hospital engaged influential leaders in healthcare, academia, mental
      health, local government, social services, and other community based organizations.

      The overall process, which includes assessment, planning, implementation, and evaluation, is
      a continuous cycle of improvement that seeks to show demonstrable improvement on key
      health priorities over the course of time. The cyclical nature of the Core Public Health
      Functions is illustrated in Figure 1.

      The next phase of Healthy Nantucket 2020 will involve broad implementation of the strategies
      through an annual action plan developed from the Community Health Improvement Plan, as
      well as monitoring and evaluation of the plan’s short-term and long-term outcome indicators.

          Figure 1: The Cyclical Nature of the Core Public Health Functions

          Source: Centers for Disease Control and Prevention (CDC), Ten Essential Public Health Services

Healthy Nantucket 2020: Nantucket 2017 Community Health Improvement Plan                                   Page 7
IV. PROCESS FROM ASSESSMENT TO PLANNING
      Nantucket Cottage Hospital and key stakeholders developed this Community Health
      Improvement Plan over the period September, 2016 - December, 2016 using the key findings
      from the CHNA. The 2015 Nantucket Community Health Needs Assessment is part of
      Nantucket Cottage Hospital’s ongoing efforts to assess the health needs of the island
      community.

      The 2015 CHNA is accessible at
      http://nantuckethospital.org/wp-content/uploads/2015/08/NCH-2015-CHNA.pdf

      The Community Health Improvement Plan utilized a participatory, collaborative approach
      guided in part by elements of the Mobilization for Action through Planning and Partnerships
      (MAPP) process.2 MAPP, a comprehensive, community-driven planning process for improving
      health, is a strategic framework that many community health coalitions across the country
      have employed to help direct their planning efforts. MAPP comprises rigorous assessment as
      the foundation for planning, and includes the identification of strategic issues and
      goal/strategy formulation as prerequisites for action. Since health needs are constantly
      changing as a community and its context evolve, the cyclical nature of the MAPP process
      allows for the periodic identification of new priorities and the realignment of activities and
      resources to address them.

      To develop a plan for improved community health, and help sustain implementation efforts,
      the community health assessment and planning process engaged community partners
      through different avenues. These partners included a cross-sector of community members
      such as health care, businesses, public safety, schools, emergency response services,
      holistic healthcare, planning and development, and transportation, as well as year-round and
      seasonal residents of the island.

      In 2016, Nantucket Cottage Hospital engaged Health Resources in Action (HRiA), a non-profit
      public health organization located in Boston, MA, as a consultant partner to provide strategic
      guidance and facilitation of the planning process, to review and provide feedback on draft
      documents and output, and to develop the resulting plan.

V. HEALTHY NANTUCKET 2020 PLAN COMPONENTS
      Development of Data-Based, Community-Identified Health Priorities
      In 2015, Nantucket Cottage Hospital conducted the Nantucket Community Health Needs
      Assessment is part of Nantucket Cottage Hospital’s ongoing efforts to assess the health
      needs of the island community. This effort included focus groups with the Healthy Community
      Collaborative and Nantucket Cottage Hospital’s Patient & Family Advisory Council, as well as
      a Quality of Life survey that was distributed widely throughout the community.

      The Steering Committee met at a kick-off meeting on September 13, 2016 to receive an
      overview of the planning process, review data outcomes from the CHNA, and review the
      proposed process and timeline for engaging community members.

2
  Advanced by the National Association of County and City Health Officials (NACCHO), MAPP’s vision is for
communities to achieve improved health and quality of life by mobilizing partnerships and taking strategic
action. Facilitated by public health leaders, this framework helps communities apply strategic thinking to
prioritize public health issues and identify resources to address them. More information on MAPP can be
found at: http://www.naccho.org/topics/infrastructure/mapp/

Healthy Nantucket 2020: Nantucket 2017 Community Health Improvement Plan                             Page 8
Three Community Forums were held to confirm the CHNA findings and gather additional
      community input. On September 20, 2016, Health Resources in Action, Inc. (HRiA) facilitated
      two community forums at Nantucket High School. A third community forum, facilitated by
      Nantucket Cottage Hospital, was held on October 2, 2016 following the Spanish Mass at St.
      Mary’s Church.

      During the Community Forums, CHNA findings were shared as well as an overview of the
      prioritization process for identifying Community Health Improvement Plan priorities.
      Participants then took part in a facilitated discussion around the CHNA findings using the
      following questions:
          1. Was there anything presented that was new or surprising to you?
          2. Would you consider the issues we discussed today to be the top health issues in this
             community? Why or why not?
          3. Do you see gaps in health care in Nantucket County? If yes, where?
          4. What is one thing that you think could be done to improve the health of your
             community?
      The following items were the main themes for health priorities that came out of the health
      needs assessment:
         1. Alcohol Use Disorders (AUDs) and Substance Use Disorders (SUDs)
         2. Access to Housing
         3. Mental Health Disorders
         4. Cancer
         5. Access to Health Care
         6. Good Schools, Jobs, and Economy
      The following additional themes were identified during the community forums:
         1.    Children/Pediatrics
         2.    Women
         3.    Language
         4.    Elder Care
      A group of over 60 key stakeholders gathered on October 6, 2016 to identify the priorities for
      the Community Health Improvement Plan. Participants used a rating tool and with defined
      criteria and a voting process to identify those health needs that were both important and
      feasible for inclusion in the plan. The following priorities and related topic areas were
      presented for their consideration:
                                                                 Need for more doctors
        1. Behavioral Health
              Alcohol Use Disorders (AUDs)                         – PCP’s and Specialty Providers
              Substance Use Disorders (SUDs)                       – Eye Health and Oral Health
              Mental Health Disorders                           Cost to go off island for care
                                                                 Integration, Collaboration, Alternatives
        2. Access to Housing
              Affordability                               6. Women’s and Children’s Health
              Availability                                      Pediatrics & Pediatric Specialists
              Homelessness                                      Early Childhood and Childcare
                                                                 Women’s Health/OBGYN
        3. Cancer
              High incidence rates of certain             7. Language
               cancers                                           Availability of translation services
                                                                 Availability of services and materials in
        4. Good Schools, Jobs, and                                multiple languages
           Economy                                               English classes
              High unemployment rates
                                                           8. Elder Care

5. Access to Health Care

Healthy Nantucket 2020: Nantucket 2017 Community Health Improvement Plan                                 Page 9
After discussion at the prioritization meeting, participants added several items to the topics
      under the proposed priorities and added Tick Borne Diseases as a ninth priority. The group
      accepted a proposal that Language be considered a cross-cutting strategy across all identified
      priorities of the Community Health Improvement Plan. It was removed from the list of priorities
      for consideration.

      Participants were presented with a list of criteria to be used to identify the 3-4 priorities for
      Healthy Nantucket 2020. An additional column/criteria for SUSTAINABILITY was added at
      the Prioritization Meeting, asking participants to consider the extent to which they thought
      sustainable change could be achieved for each health issue.

                                    - Burden (magnitude and severity; economic cost; urgency) of the
           RELEVANCE                  problem
         How Important Is It?       - Community concern
                                    - Focus on equity and accessibility
                                    - Ethical and moral issues
       APPROPRIATENESS              - Human rights issues
      Should the Community of       - Legal aspects
         Nantucket Do It?           - Political and social acceptability
                                    - Public attitudes and values
                                    - Effectiveness
               IMPACT               - Coverage
       What will the Community      - Builds on or enhances current work
      of Nantucket Get Out of It?   - Can move the needle and demonstrate measureable outcomes
                                    - Proven strategies to address multiple wins
                                    - Community capacity
                                    - Technical capacity
           FEASIBILITY              - Economic capacity
        Can the Community of        - Political capacity/will
          Nantucket do It?          - Socio-cultural aspects
                                    - Ethical aspects
                                    - Can identify easy short-term wins
          SUSTAINABILITY            - Ability to maintain efforts/activities beyond the initial CHIP timeframe

      Participants calculated an overall rating for each health issue by adding their five ratings.
      Each participant received three dots stickers and were asked to place their dots on the three
      key health issues that received the three highest overall Total Ratings on their rating
      worksheet. Participants used their personal judgment to break any ties. The results of the dot
      voting process are depicted in the table below.

               Key Health Issues                                                Number of Votes
                1.   Behavioral Health                                                   45
                2.   Access to Housing                                                   23
                3.   Cancer                                                              5
                4.   Good Schools, Jobs, and Economy                                     12
                5.   Access to Health Care                                               28
                6.   Women’s and Children’s Health                                       23
                7.   Language
                8.   Elder Care                                                           5
                9.   Tick-Borne Diseases (added by participants)                          4

Healthy Nantucket 2020: Nantucket 2017 Community Health Improvement Plan                                  Page 10
Priorities Identified for Healthy Nantucket 2020
          1.   Behavioral Health
          2.   Access to Healthcare
          3.   Women’s and Children’s Health
          4.   Access to Housing

      The Plan’s Strategic Framework
      Following the prioritization meeting, key stakeholders met in November for two, half-day
      planning sessions facilitated by HRiA consultants to develop the core elements of the
      Community Health Improvement Plan. In the first planning session, participants developed
      and revised goals, and developed draft objectives and indicators. In the second planning
      session, participants finalized their draft objectives and indicators, and developed strategies to
      meet each objective.

      Working group participants were provided sample evidence-based strategies from a variety of
      resources including The Community Guide to Preventive Services, County Health Rankings,
      Healthy People 2020, and the National Prevention Strategy. Indicators for each objective
      were identified based on data available from the CHNA, using whenever possible, targets
      outlined in Healthy People 2020 (HP2020).

      HP2020 is the federal government's prevention agenda for building a healthier nation. It is a
      statement of national health objectives designed to identify the most significant preventable
      threats to health and to establish national goals to reduce these threats.

      The draft Community Health Improvement Plan was completed and disseminated to working
      group members for electronic review and feedback. This feedback was incorporated into the
      final draft of the plan, which will be used to guide annual implementation plans.

VI. HEALTHY NANTUCKET 2020
      Real, lasting community change stems from critical assessment of current conditions, an
      aspirational framing of the desired future, and a clear evaluation of whether efforts are making
      a difference. Outcome indicators tell the story about where a community is in relation to its
      vision, as articulated by its related goals, objectives, and strategies. Targets for identified
      outcome indicators have been established using baseline data provided in the Community
      Health Needs Assessment, wherever possible. Where no data were readily available,
      objectives were noted as “Developmental” and a primary strategy will be to collect and
      analyze data and determine a baseline for successive annual comparisons.

      The following pages outline the Goals, Objectives, Strategies, Outcome Indicators, and
      Potential Partners/Resources for the four health priority areas outlined in the Community
      Health Improvement Plan. See Appendix B for a glossary of terms used in this plan.

Healthy Nantucket 2020: Nantucket 2017 Community Health Improvement Plan                         Page 11
Priority Area 1: Behavioral Health
        When quality of life survey respondents were asked to identify the three most important health
        problems on Nantucket (e.g., those that have the greatest impact on overall community
        health), the leading problems identified were: alcohol and substance use disorders (63.4%);
        access to housing (48.2%); mental health disorders (35.3%); and cancers (20.5%).3

        Survey respondents cited substance use disorders as the most pressing health problem on
        Nantucket. Alcohol and drug use disorders on Nantucket were also key themes discussed in
        focus groups. These problems are not new on the island, but there is increased attention and
        awareness due to recent opioid overdoses, the growth of alcohol-fueled events on Nantucket.4

        Quality of life survey respondents cited mental health disorders (anxiety, depression, etc.) as
        the third most important health problem on Nantucket.5 Focus group participants also noted
        the issue of mental health on Nantucket and referred to the number of suicides over the past
        year among middle-aged men. They also acknowledged the island’s existing clinicians,
        providers, and agencies are all over-extended given the extent of the issues and noted the
        great need for an inpatient treatment capacity.6

        Goal 1: Enhance overall wellness for the Nantucket community through the
                implementation of an effective and collaborative Behavioral Health System.
                  Objectives

                  1.1: By 2020, decrease suicide attempts by 10% a year.
                             Outcome Indicators             Baseline         2020 Target        Data Source
                        Number of suicide                  34 per year        < 25 per      Nantucket Cottage
                        attempts/ideations                    2015              year        Hospital

                        Number of suicide deaths           0 per year         0 per year    County Clerk
                                                           2013-2014                        Certification

                                                           1 per year
                                                           2015-2016

                        Strategies
                        1.1.1:   Educate all employers (e.g., small and large employers, Builder’s Association,
                                 Chamber of Commerce), on Nantucket and implement Employee Assistance
                                 Programs to recognize and refer high risk employees.
                        1.1.2:   Expand education about suicide risk by assessing and enhancing Signs of
                                 Suicide (SOS) program in Nantucket Schools.
                        1.1.3:   Reduce the stigma surrounding suicidal thoughts by implementing an
                                 evidenced-based peer-to-peer program for the reduction of suicide in the
                                 Middle and High School (e.g., incorporate in existing health education or
                                 establish a hired position).
                        1.1.4:   Establish a full-service mobile crisis unit.
                        1.1.5:   Increase the availability to access needed behavioral health services.

3
    NCH 2015 Community Health Needs Assessment, page 12
4
    NCH 2015 Community Health Needs Assessment, page 15
5
    NCH 2015 Community Health Needs Assessment, page 15
6
    NCH 2015 Community Health Needs Assessment, page 16

Healthy Nantucket 2020: Nantucket 2017 Community Health Improvement Plan                                Page 12
1.2   By 2020, decrease the need for emergency evaluation for mental health
                      and substance use disorders by 10% per year.
                                Outcome Indicators            Baseline     2020 Target        Data Source
                       Number of ED admissions to               233           170         Nantucket Cottage
                       hospital                                                           Hospital (NCH)
                       Number of mobile crisis                  TBD           TBD
                       evaluations

                      Strategies
                      1.2.1:  Increase psycho-education to the community about mental health and
                              substance use disorders.
                      1.2.2: Expand outreach to high risk populations.
                      1.2.3: Expand mental health and substance use disorders screening (e.g., Employee
                              Assistance Program (EAP), tracks, schools, hospitality).
                      1.2.4: Develop sober hobbies that are free and accessible (e.g., art, music,
                              exercise/gym).
                      1.2.5: Create community campaign to integrate mental health into ACK festivals (e.g.,
                              film, book).
                      1.2.6: Hire staff to reduce wait lists for mental health services.
                      1.2.7: Expand funding for English Language Learner (ELL) providers, outreach, and
                              screening tools.
                      1.2.8: Establish a wellness center that houses all levels of care (e.g., Intensive
                              Outpatient Program (IOP), Crisis Stabilization Unit (CSU)). (see also 1.5.3)
                      1.2.9: Offer and fund complementary and alternative medicines/therapies (CAM)
                              (e.g., art, pet, narrative).
                      1.2.10: Offer unified crisis response services in all languages.

                1.3   By 2020, reduce reported/identified overdoses by 10% per year.
                               Outcome Indicators              Baseline     2020 Target       Data Source
                       Number of first responder                 11              8        Nantucket Fire
                       interventions                                                      Department & Police
                                                                                          Department

                      Strategies
                      1.3.1:   Provide info/training to opioid users and bystanders (friends, family, co-users)
                               on overdose (OD) risk factors including: danger of using alone, use of benzos,
                               ETH or other drugs at the same time, re-initiation of use after a period of
                               abstinence (i.e., lower tolerance).
                      1.3.2:   Identify and agree upon a screening tool to be used by those who screen
                               individuals at risk of overdose.
                      1.3.3:   Utilize screening tool(s) to identify individuals at risk through screening by
                               emergency department (ED), EMT, hospital staff, primary care physicians
                               (PCPs), schools.
                      1.3.4:   Distribute information about causes and consequences of OD to victims and
                               bystanders, especially those refusing transport, via EMT and first responders.
                      1.3.5:   Provide information on how to reduce OD risk for opioid users who are
                               admitted, using a harm reduction model.
                      1.3.6:   Educate users/bystanders on recognizing signs of OD and appropriate
                               management strategies – rescue breathing, Narcan, and contacting EMS.
                      1.3.7:   Provide multiple treatment options and support (Medication-Assisted Therapy,
                               Group Therapy, etc.).
                      1.3.8:   Enhance the Court Diversion Program for adults and children, including
                               random probation.

Healthy Nantucket 2020: Nantucket 2017 Community Health Improvement Plan                               Page 13
1.4   Increase awareness of mental health and substance use disorders, and
                      preventive services for all ages in the most prevalent languages spoken.
                               Outcome Indicators              Baseline    2020 Target         Data Source
                       Number of exposures/programs              TBD          TBD
                       Addiction Awareness Workshop            12/year        TBD        Behavioral Health
                                                              (monthly)                  Task Force
                       NAMI run 12-week educational             1/year        TBD        Behavioral Health
                       course for people with loved ones                                 Task Force
                       who have a mental illness
                       Educational community                   6/year         TBD        Behavioral Health
                       presentations and/or forums                                       Task Force
                       Educational presentation for all        2/year         TBD        Behavioral Health
                       grade level students (mainly                                      Task Force
                       middle and high school), on
                       bullying, substance abuse and/or
                       depression/suicide prevention

                      Strategies
                      1.4.1:   Provide educational resources, activities and healthy alternatives for
                               prevention of mental health and substance use disorders beginning with pre-
                               natal and post-partum care, continuing through all stages of life.
                      1.4.2:   Adopt system wide evidence-based social and emotional learning program for
                               all students K-12.
                      1.4.3:   Implement holistic health alternative practices for students (i.e., incorporate
                               creative arts, yoga, mindfulness, as post or in school activities).
                      1.4.4:   Change the community and others’ perception of Nantucket as a “party”
                               community (e.g., sober, fun activities 1.2.7, Chamber of Commerce, Nantucket
                               Police Department (NPD), EMT, NCH, schools, nonprofit organizations, Town
                               of Nantucket, etc. to address it).

                1.5   By 2020, reduce barriers to accessing clinical and community
                      preventative mental health and substance use disorders services,
                      especially among populations at greatest risk.
                                Outcome Indicators            Baseline     2020 Target        Data Source
                       Wait Time                               TBD            TBD
                       Usage of services (e.g. number of       TBD            TBD
                       visits to MH providers)

                      Strategies
                      1.5.1:   Research funding/reimbursement and advocacy for clinical services (*psych
                               NP/LICSW/case manager).
                      1.5.2:   Create navigation hub and global communication to community.
                      1.5.3:   Create central billing services for behavioral health.
                      1.5.4:   Create Wellness Center for integrated behavioral health services: see also
                               1.2.8)
                                  • Psychiatrist
                                  • Psych Nurse Practitioner (NP)
                                  • Licensed Independent Clinical Social Worker (LICSW)
                                  • Case Manager
                                  • Complementary and Alternative Medicines (CAM)
                               Barriers: insurance, finances, language, income, education/cultural
                               differences, number of clinicians, transportation, night/weekend services,
                               flexible work schedules (work with employers)

Healthy Nantucket 2020: Nantucket 2017 Community Health Improvement Plan                               Page 14
Potential Partners and Resources for Behavioral Health
           Alliance for Substance Abuse Prevention (ASAP)
           Alternative therapists
           Artists’ Association of Nantucket
           Cape & Island Suicide Prevention Coalition
           Fairwinds / Private Practice / any other mental health provider on island
           Gosnold Cape Cod
           Nantucket Health Department
           Large Nantucket employers
           MA State / Fellowship Health resources
           Mentor Youth Nantucket (MYN)
           Nantucket Boys & Girls Club
           Nantucket Chamber of Commerce
           Nantucket Cottage Hospital
           Nantucket Police Department
           Nantucket Fire Department
           National Alliance of Mental Illness (NAMI)
           Primary care [physicians and pharmacies
           Public schools, community schools and private schools
           Safe Harbor

Healthy Nantucket 2020: Nantucket 2017 Community Health Improvement Plan                Page 15
Priority Area 2: Women’s and Children’s Health
      Participants at the community forums raised the issues of access to OBGYN services,
      pediatricians, and pediatric specialists. These have been consistent challenges over time and
      were highlighted as health priorities that need to be addressed in this plan. Participants also
      wanted to raise awareness of the challenges faced by working parents on the island when
      there is a shortage in options available for child care. This was noted as a gap along with
      continuum of care for people living on the island.

      Goal 2: Improve the health, safety, and well-being of all women, infants, children, and
              families of the diverse Nantucket community.
                Objectives

                2.1: By 2020, increase the number of licensed slots for early childhood care
                     by 75 slots from children birth – pre-kindergarten.
                               Outcome Indicators              Baseline     2020 Target         Data Source
                       Number of licensed slots for early        230           305        Early childhood
                       childhood care                                                     providers

                      Strategies
                      2.1.1:   Create a central registration to evaluate the number of licensed daycare
                               positions available
                      2.1.2:   Increase availabilities for infants/toddlers and preschool children within public
                               schools, community schools and private schools to accommodate parents
                               working full time.
                      2.1.3:   Educate potential and existing providers on how to apply, obtain and maintain
                               licensure.
                      2.1.4:   Explore opportunities for collaboration and operational cost-savings through an
                               early childhood cohort/collaborative.
                      2.1.5:   Advocate to developers of new multi-purpose construction that they consider
                               space that can be used for early childhood education.
                      2.1.6:   Identify additional opportunities for space within existing buildings.
                      2.1.7:   Identify grant opportunities to support tuition assistance for childcare.

                2.2: By 2020, educate the community about existing services and resources
                     that are available for women’s and children’s healthcare.
                                Outcome Indicators            Baseline     2020 Target         Data Source
                       Number of education/promotional         TBD            TBD
                       encounters
                       Utilization of online app                TBD            TBD
                       Participation at education forums        TBD            TBD

                      Strategies
                      2.2.1:   Identify education resources and services available on-island.
                      2.2.2:   Partner with Patient & Family Advisory Council (PFAC) to create an Island
                               Community Partners Support Model for MotherWoman (state funded program).
                      2.2.3:   Educate expectant and new mothers and all women on warning signs and
                               symptoms of mood disorders.
                      2.2.4:   Explore and utilize traditional and non-traditional avenues for communicating
                               existing education resources and messaging (e.g., grocery stores, churches,
                               Boston Pops concert).

Healthy Nantucket 2020: Nantucket 2017 Community Health Improvement Plan                                Page 16
2.2.5:  Identify key residents and resources within specific communities who can help
                              deliver educational messages.
                      2.2.6: Identify which websites have and do not have the ability to translate in different
                              languages and provide funding for integrating translation services where
                              needed.
                      2.2.7: Develop an online app in multiple languages that lists existing services and
                              resources.
                      2.2.8: Collaborate and create forums with island organizations and island resources
                              (Nantucket Community School and NCH PediPFAC have this as a priority work
                              plan) to educate the community.
                      (See also Objective 3.1 and 4.5)

                2.3: By 2020, establish a baseline rate of preventative dental visits for children
                     under age 2.
                               Outcome Indicators            Baseline      2020 Target       Data Source
                       Baseline rate of preventative          TBD             TBD        Dental providers
                       dental visits is established

                      Strategies
                      2.3.1:   Identify providers on island who provide pediatric dental care, as well as
                               potential providers through state agencies.
                      2.3.2:   Create a dental collaborative of Nantucket to help align best practices among
                               Dentists and PCPs.

                2.4: By 2020, decrease the rate of dental caries for children under age 2 by
                     x%.*
                               Outcome Indicators            Baseline      2020 Target       Data Source
                       Increase number of preventative        TBD             TBD        Dental providers
                       dental visits

                      Strategies
                      2.4.1:  Establish a rate of dental caries for children under age 2.
                      2.4.2:  Provide dental education in appropriate language as part of newborn hospital
                              discharge and well-child visits.
                      2.4.3: Include dental access/education in online app (see Objective 2.2.8).
                      2.4.4: Solicit community organizations (e.g. golf clubs, foundations, etc.) to create a
                              general fund to help support pediatric dental care.
                      2.4.5: Advocate for fluoridating public water in the community.
                      2.4.6: Work with the Nantucket Public Health Department to educate families about
                              the importance of fluoride supplementation and the importance of preventative
                              check-ups and cleanings for children.
                      * Rate will be established following establishment of current rate of dental caries for
                              children under age 2.

Healthy Nantucket 2020: Nantucket 2017 Community Health Improvement Plan                               Page 17
2.5: By 2020, increase the number of children entering the educational system
                     (including private and public) who have had an annual pediatric well visit
                     by 50%.
                               Outcome Indicators             Baseline     2020 Target        Data Source
                       Number of children who answer           TBD            TBD        School enrollment
                       “yes” to well visit question when                                 forms
                       entering the educational system

                      Strategies
                      2.5.1:   Connect families to pediatric provider options at pre-natal visits with a warm
                               introduction.
                      2.5.2:   Identify community leaders to build trust with vulnerable and undocumented
                               populations and connect them with existing services.
                      2.5.3:   Provide education through churches and other organizations on rights and
                               responsibilities for access to health care.
                      2.5.4:   Communicate existing care and any expansion of services, for example a
                               Pediatric Walk-In Care, through traditional and non-traditional communication
                               strategies.
                      2.5.5:   Expand the use of Pediatric Nurse Practitioners.

                2.6: By 2020, educate families and children on a balanced and healthy diet.
                              Outcome Indicators              Baseline     2020 Target        Data Source
                       Number of educational sessions          TBD            TBD
                       Number of participants at               TBD            TBD
                       educational sessions

                      Strategies
                      2.6.1:   Identify organizations that host a high volume of families and children, and
                               utilize these as a forum to provide education on a balanced and healthy diet,
                               obesity, and nutritional impact on dental issues.
                      2.6.2:   Outreach to new immigrant population and share strategies to adapt their diets
                               with new foods that promote a balanced and healthy diet.

      Potential Partners and Resources for Women’s & Children’s Health
           Childcare Providers
           Churches
           Early childhood education
           Grocery stores
           Pedi PFAC
           School Systems
           Town of Nantucket

Healthy Nantucket 2020: Nantucket 2017 Community Health Improvement Plan                               Page 18
Priority Area 3: Access to Health Care
        Nantucket Cottage Hospital is the only medical facility on the island providing primary, urgent,
        emergency and surgical care, as well as outpatient services and appointments with medical
        and surgical specialists.7 In spite of the wide range of services provided by the hospital, there
        is still a shortage of providers overall in the community. Nantucket’s entire population is living
        in a federally designated “Heath Professional Shortage Area”, compared to 14.6% of residents
        statewide.8

        Quality of life survey respondents noted that access to healthcare is the number one factor
        that defines a healthy community and just over half of respondents stated that they were
        satisfied with the existing health system on Nantucket.9

        Community forum participants noted the high cost of having to go off-island for medical care,
        particularly for specialists and procedures not available on island.

        Goal 3: Enhance access to healthcare for the Nantucket community.
                  Objectives

                  3.1: By 2020, compile and coordinate the dissemination of information about
                       traditional and alternative healthcare services available.
                               Outcome Indicators              Baseline     2020 Target        Data Source
                        Number of hits to the website           TBD            TBD
                        Survey of residents to rate the         TBD            TBD
                        tool
                        Number of collaborators                  TBD           TBD
                        Number of resources distributed          TBD           TBD
                        Number of referrals                      TBD           TBD

                        Strategies
                        3.1.1:  Identify existing medical and healthcare resources and services.
                        3.1.2:  Establish and encourage continued communication between existing entities.
                        3.1.3:  Update information across all existing media and advertising outlets currently
                                available to include newly identified resources.
                        3.1.4: Determine the necessity of a new resource data-base.
                        3.1.5: Disseminate information through multiple avenues (virtual, audio, radio, print).
                        (See also 2.4 and 4.5)

7
    NCH 2015 Community Health Needs Assessment, page 18
8
    NCH 2015 Community Health Needs Assessment, page 18
9
    NCH 2015 Community Health Needs Assessment, page 19

Healthy Nantucket 2020: Nantucket 2017 Community Health Improvement Plan                                Page 19
3.2: By 2020, increase awareness of preventative and wellness services as
                     viable options for care.
                                Outcome Indicators           Baseline      2020 Target        Data Source
                       Utilization of preventative and        TBD             TBD
                       wellness services

                      Strategies
                      3.2.1: Identify existing/available preventative and wellness services.
                      3.2.2: Utilize multiple outreach efforts in multiple languages to promote options for
                             care.
                      3.2.3: Encourage collaboration and referrals between providers on-island and off-
                             island.
                      (See also 3.1)

                3.3: By 2020, increase the current number of year-round primary care
                     physicians (PCPs) by a net gain of two (2) and increase physician
                     extenders proportionally.
                               Outcome Indicators             Baseline     2020 Target        Data Source
                       Number of primary care                    6              8                NCH
                       physicians
                       Number of extenders (PAs, NPs)            6              8                 NCH

                      Strategies
                      3.3.1:   Identify barriers and expand methods of recruiting PCPs and extenders to the
                               island of Nantucket, taking into consideration the national shortage.
                      3.3.2:   Identify criteria and outreach to potential candidates.
                      3.3.3:   Establish methods/standards for retention.
                      3.3.4:   Identify barriers PCP’s face in accepting a position on Island.
                      3.3.5:   Expand programs to “grow our own” healthcare professionals, foster education,
                               and coordinate scholarship requirements.
                      3.3.6:   Involve community members in the recruitment and retention process.

                3.4: By 2020, establish year-round public transportation.
                              Outcome Indicators              Baseline     2020 Target       Data Source
                       Ridership                              287,042       496,842       Nantucket Regional
                                                                                           Transit Authority
                                                                                           (NRTA) Farebox
                                                                                               Reports

                      Strategies
                      3.4.1:   Analyze current available sources for year-round transportation.
                      3.4.2:   Identify funding sources (i.e. Medicaid).
                      3.4.3:   Communicate the services available.
                      3.4.4:   Expand transportation services.

Healthy Nantucket 2020: Nantucket 2017 Community Health Improvement Plan                                Page 20
3.5: By 2020, increase the awareness of off-island transportation options for
                     medically-necessary travel.
                                Outcome Indicators           Baseline      2020 Target      Data Source
                       Pre-post survey of residents of          0             10%        NRTA/Others
                       level of awareness

                      Strategies
                      3.5.1:   Identify existing off-island services.
                      3.5.2:   Communicate/collaborate available services among entities providing
                               transportation.
                      3.5.3:   Promote available services and how to access them.
                      3.5.4:   Establish financial sustainability to support increased utilization.

      Potential Partners and Resources for Access to Healthcare
           Chamber of Commerce
           Elder services
           Four winds
           Local advisory councils, association, coalitions
           Media (radio, TV, print)
           NCH Social Services Department
           NRTA
           Rotary Club
           Saltmarsh Senior Center
           Social Media – Facebook, Instagram, Twitter, YouTube, Vimeo, Snapchat, etc.
           Town Website

Healthy Nantucket 2020: Nantucket 2017 Community Health Improvement Plan                              Page 21
Priority Area 4: Access to Housing
        A recent report conducted by Housing Nantucket estimated that new homeownership is
        prohibitive to 90% of the island’s households. The lack of price-appropriate housing for people
        who work on Nantucket throughout the year is a barrier to a decent quality of life for workers
        and their families and an obstacle to hiring qualified people for some specialized positions. As
        numerous past studies and reports show, the stock of affordable housing on Nantucket has
        been inadequate for a very long time.10 Quality of life survey respondents listed access to
        housing as the second most important health problem on Nantucket. In addition, a primary
        theme throughout both focus groups was the lack of affordable housing options on the island
        for both year-round and seasonal residents.11

        The high cost of housing on Nantucket (presents a particular challenge in regards to recruiting
        and maintaining adequate levels of an essential services workforce. The median home value
        of $929,700 on Nantucket is almost three times the statewide value of $330,100. Moreover,
        almost half of homes (43.0%) on Nantucket cost $1 million or more, compared to 3.4%
        statewide.12

        Goal 4. Ensure access to safe, stable, affordable, year-round housing across all
                income levels on Nantucket.
                  Objectives

                  4.1: By the end of 2017, advocate for the passage of the Affordable Housing
                       Bank.
                                   Outcome Indicators            Baseline    2020 Target        Data Source
                         Passage of the current proposal by        N/A       Passed in         State Records
                         the State in Q1 of 2017                             Q1 2017
                         If not passed, advocate that it be        N/A
                         heard again
                         If no state action, then reauthorized     N/A        Passed at       Town Records
                         at April 2017 annual town meeting                      Town
                                                                               Meeting

                        Strategies
                        4.1.1:   Lobby the Legislature – (Hire, self-lobby, or internal Nantucket resources?).
                                   • Establish relationships with the two (2) new officials (State Rep and State
                                       Senator).
                                   • Involve leadership of Board of Selectmen.
                                   • Involve builder and realtor community.
                                   • Reauthorize at this year’s (2017) Town Meeting.
                                   • Utilize media (e.g., letters to editor, social media) to raise awareness.
                                   • Seek the support of Massachusetts Governor’s office
                        4.1.2:   Reach out to Martha’s Vineyard towns and organizations to learn about their
                                 housing initiatives and make alliances where appropriate.
                        4.1.3:   Reach out to MA Governor’s office.
                        4.1.4:   Affordable Housing Trust Fund to further define the use of proceeds from the
                                 Housing Bank.

10
     NCH 2015 Community Health Needs Assessment, page 9
11
     NCH 2015 Community Health Needs Assessment, page 9
12
     NCH 2015 Community Health Needs Assessment, page 9

Healthy Nantucket 2020: Nantucket 2017 Community Health Improvement Plan                                Page 22
4.2: By 2020, identify and adopt zoning strategies to be used to create
                     incentives for affordable housing on Nantucket.
                                Outcome Indicators             Baseline      2020 Target       Data Source
                       Meetings with planning                    N/A         Get passed    Planning Office
                       department & ideas generated
                       Zoning articles drafted and               N/A         Get passed    Planning Office
                       submitted to Town Meeting, if
                       appropriate
                       Articles adopted by Town Meeting          N/A         Get passed    Planning Office

                      Strategies
                      4.2.1:   Research what other communities are trying that is working (focus on other
                               island and/or resort/vacation communities, and communities with high cost of
                               housing).
                      4.2.2:   Work with the Nantucket Planning and Economic Development Commission
                               (NP&EDC) to educate homeowners and developers about existing zoning that
                               addresses affordable housing and possible proposed changes that may be in
                               discussion.
                      4.2.3:   Engage realtors to learn their thoughts on zoning.
                      4.2.4:   Conduct a community-wide visioning exercise on what Nantucket might look
                               like in 2025.
                      4.2.5:   Provide a concept/recommendation for zoning change(s), if appropriate.

                4.3: By 2020, expand and promote the existing First Time Home Buyers
                     Education program to include online and multi-lingual offerings.
                               Outcome Indicators             Baseline     2020 Target         Data Source
                       Offered twice per year in English         2              2           Housing Nantucket
                       (9-hour program offered on
                       consecutive Wednesdays)
                       Number of people who attend or          TBD             TBD
                       participate in the educational
                       programs
                       Online library                                       Complete

                      Strategies
                      4.3.1:   Engage translators for multiple languages (volunteers if possible) to translate
                               English program.
                      4.3.2:   Utilize existing cultural gatherings to promote the First Time Home Buyers
                               Education program.
                      4.3.3:   Offer childcare for program participants.
                      4.3.4:   Explore the use of translators or whisper translation technologies for all
                               educational programs.
                      4.3.5:   Explore funding to offer online program at a reduced cost or free of charge.
                      4.3.6:   Engage audio/video/web resources to generate online library in multiple
                               languages.
                      4.3.7:   Research the preferred delivery method of the education program into
                               Spanish, Bulgarian, Portuguese, Russian.
                      4.3.8:   Promote via objective 4.5.

Healthy Nantucket 2020: Nantucket 2017 Community Health Improvement Plan                                Page 23
4.4: By 2020, establish a down payment assistance program for essential
                     services workforce.
                              Outcome Indicators              Baseline     2020 Target         Data Source
                       Decrease percent down                   TBD            TBD         Affordable Housing
                       payment                                                            Trust Fund (AHTF)
                       Gap financing                           TBD            TBD         AHTF

                      Strategies
                      4.4.1:   Form a task force (include essential service providers, bankers, realtors,
                               stakeholders, etc.)
                      4.4.2:   Define the criteria for a critical Nantucket workforce program.
                      4.4.3:   Identify funding needed, source, and sustainability plan for long term funding.
                      4.4.4:   Explore the business model (look at other established, successful models).
                      4.4.5:   Define all relevant parameters of the program (pay back, resale, loans, etc.).
                      4.4.6:   Define the application process.
                      4.4.7:   Determine who will administer the program (local bank, non-profit: new or
                               existing?).
                      4.4.8:   Promote via Objective 4.5.

                4.5: By 2020, create and market a public clearing house to raise awareness of
                     the existing resources that help with housing and housing information for
                     owners and tenants.
                              Outcome Indicators              Baseline     2020 Target         Data Source
                       AHTF established                                    Established
                       Clearing House                                      Established

                      Strategies
                      4.5.1: Identify what to include in the Clearing House, for example home share
                             options.
                      4.5.2: Create a Task Force to reach out to different organizations to gather and
                             translate information in be included.
                      4.5.3: Establish an online home for the Clearing House.
                      4.5.4: Establish a way to keep the info up-to-date.
                      4.5.5: Include a Housing Booth at Community Health Fairs and other community
                             events.
                      4.5.6: Design and develop written materials in multiple languages to promote the
                             Clearing House.
                      4.5.7: Distribute written materials around town to convenient locations (need to
                             determine where).
                      4.5.8: Utilize media to advertise the Clearing House (e.g., paper, local television,
                             radio, and social media).
                      (See also Objective 2.4 and 3.1)

Healthy Nantucket 2020: Nantucket 2017 Community Health Improvement Plan                                Page 24
Potential Partners and Resources for Access to Housing
            Banks
            Churches
            Community Preservation Committee (CPC)
            Fire
            Hospital
            Housing Nantucket
            Library/Athenaeum
            Major Employers
            Media
            Nantucket Planning and Economic Development Commission (NP&EDC)
            Other funding partners
            Police
            Preservation Groups
            Realtors
            Schools
            Town Departments

VII. NEXT STEPS
       The components included in this report represent the strategic framework for a data-driven,
       Community Health Improvement Plan. Nantucket Cottage Hospital, Healthy Nantucket 2020
       workgroups, partners, stakeholders, and community residents, will continue finalizing,
       implementing, and tracking plan progress over the coming year. A progress report will
       illustrate performance and will guide subsequent annual implementation planning.

VIII. SUSTAINABILITY
       Nantucket Cottage Hospital, Healthy Nantucket 2020 workgroups, partners, stakeholders, and
       community residents, will continue the process by refining the specific annual action steps,
       assign lead agencies and personnel, and identify resources for each priority area.

       NCH will provide executive oversight for the improvement plan, progress, and process,
       identifying additional partners that are integral to success of the plan. Community dialogue
       sessions and forums will occur in order to engage residents in the implementation where
       appropriate, share progress, solicit feedback, and strengthen the plan. Regular
       communication through presentations, meetings and via the hospital website to community
       members and stakeholders will occur throughout the implementation. New and creative ways
       to feasibly engage all parties will be explored at the aforementioned engagement
       opportunities.

 Healthy Nantucket 2020: Nantucket 2017 Community Health Improvement Plan                    Page 25
You can also read